$Unique_ID{BRK02011}
$Pretitle{}
$Title{Establishing a Course of Treatment for Breast Cancer}
$Subject{lumpectomy breast cancer breasts chest radiation hormone treatments
hormone treatment mastectomy tumor tumors metastasis staging lymph nodes lymph
node axilla estrogen progesterone receptor assays hormone therapy biopsy
biopsies}
$Volume{}
$Log{
Anatomy of the Breast*0002601.scf
Anatomy of the Female Chest*0005301.scf
Simple Mastectomy*0005302.scf
Modified Radical Mastectomy*0005303.scf
Standard Radical Mastectomy*0005304.scf}

Copyright (c) 1993  Tribune Media Services, Inc.


Establishing a Course of Treatment for Breast Cancer


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QUESTION:  I had a lumpectomy done a few days ago on my right breast.  The
tumor was the size of a golf ball.  Now comes the question:  What should be
done next?  Radiation or hormone treatments - or should I get a mastectomy?  I
am 67 years old, and thought I was healthy.  I read your column daily, please
advise.  Thank you.

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ANSWER:  The treatments following a lumpectomy, or removal of a tumor from the
breast (rather than removing the breast itself) depend upon a number of
variables.  Doctors have developed treatment protocols that follow precise
guidelines that result from research on cancers of different natures, severity
and the likelihood that it has already spread to different areas of the body
(metastasis).  The earlier the cancer is discovered and treated, the less
likely it is that is has spread.
     A system of classification called "Staging" is used to establish
treatment.  In your case, the size of the cancer is an important factor, for
it is small.  The nature of the cancer cells that were discovered when the
tissue was analyzed under the microscope, is another component that is taken
into consideration.  During your lumpectomy, the surgeon also removed some
lymph nodes from your armpit area (axilla) and these too were scrutinized
under the microscope.  The findings of this examination also are considered,
for less therapy will be required if the nodes contained no cancer cells.  The
tissues are also tested for certain proteins using the Estrogen and
Progesterone Receptor Assays.  This test gives an indication as the
effectiveness of using hormone therapy after the lumpectomy.
     Radiation therapy is now standard for most patients after either a
lumpectomy or simple breast removal.  Mastectomy is only considered for
patients who are poor candidates for radiation therapy.
     As you can see, your treatments will depend upon the results of your
staging, which in turn depends upon the factors I have just described.  The
good news is that the percentage of 5 year cures has risen dramatically since
these staging protocols have been used.

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The material contained here is "FOR INFORMATION ONLY" and should not replace
the counsel and advice of your personal physician.  Promptly consulting your
doctor is the best path to a quick and successful resolution of any medical
problem.